﻿Frontier Surgeon

The Story of Dr. Ephraim McDowell

On Christmas Day 1809, a thousand miles from the nearest hospital and thirty-five years before the development of anesthesia, Dr. Ephraim McDowell removed a 22-pound ovarian tumor from the abdomen of a Kentucky woman. It was the world's first ovariotomy, and it eventually brought McDowell worldwide acclaim as the Father of Abdominal Surgery. Ephraim McDowell was born in Rockbridge, Virginia. His father, Samuel, was a colonel in the American Revolution, and was asked by President George Washington to come to Kentucky to settle land claim deeds. Samuel McDowell moved to Danville, became a judge, and played a key role in Kentucky 's quest for statehood, serving as president of the 1792 constitutional convention. Little is known about Ephraim's early education. At 16, he went to Staunton, Virginia to apprentice under the noted physician Alexander Humphreys. Dr. Humphreys had studied in Scotland at the University of Edinburgh. He encouraged his students to do the same. In 1792, young McDowell went to Scotland , where he studied with John Bell, the most celebrated surgeon in Europe. Returning to Danville in 1795, McDowell began a medical practice. He soon won a regional reputation as an accomplished anatomist and surgeon. Other practitioners consulted him about their difficult cases. In 1802, McDowell married Sarah Shelby, the daughter of Kentucky 's first governor, Isaac Shelby. The couple had six children. A frontier doctor saw some patients in his office, and rode many miles on horseback to see others. McDowell met Jane Todd Crawford when he was called to Green County by her physicians. They believed the 46-year-old woman was pregnant with twins, but she had not delivered and was in excruciating pain. McDowell determined that she actually was suffering from a large ovarian tumor, which moved easily from side to side and caused her abdomen to hang down to her knees. He told Crawford that the most eminent surgeons of England and Scotland were convinced that opening the abdomen to remove a tumor meant certain death from inflammation. He also recalled telling her that "if she thought herself prepared to die, I would take the lump from her if she could come to Danville." He wanted to personally attend to her after the operation. McDowell and Crawford both understood that It was an experiment, and her only hope of survival. She rode for several days to get to Danville, resting the tumor on the saddle horn. A religious man, McDowell performed the surgery on Christmas Day 1809, hoping the holy day would be propitious. As he often did before surgery, he scribbled a prayer on a piece of paper and placed it in his pocket. While Crawford sang hymns to distract herself from the pain, the surgeon, assisted by his nephew, removed a tumor weighing just over 22 pounds. Five days later, he found Crawford standing, making her bed. In less than a month, she was on the way home. She lived another 32 years. McDowell's boldness, nurtured perhaps by the spirit of the frontier, saved Crawford's life and paved the way for surgeries that have since saved untold numbers of lives. He himself performed the procedure at least eleven more times with only one death.﻿